TEEN HEALTH:

MINDING THE GENDER GAP: What About Our Boys?

by Dr. Ann L. Engelland

(February 15, 2006) Headlines everywhere, most recently the front page of the New York Times, warn that boys may be left behind. That they are succeeding less than girls. That they drop out of school more often. That the girls are surpassing them in SAT scores, college admissions, job placement and so forth.

So, for mothers of boys out there, we need to ask: “Is there cause for concern?”

Concern about boys has been a hot issue among those of us in the adolescent medicine profession for several years now. Despite significantly more dangerous risk-taking behaviors and higher mortality rates, adolescent males are seen far less by doctors and health professionals than girls. When they are seen, the visit is often a perfunctory sports physical, done in a gym, without sufficient privacy to conduct a legitimate health assessment.

How is that possible? What does that have to do with success and boys? The hallmark of adolescent medicine is the recognition that what makes teens unhealthy is not just Strep throat or broken bones or even the occasional concussion but also exposure to excessive drinking; unsafe or unethical sexual practices; stresses related to growth, puberty and body issues; and unsafe driving, swimming, and sports playing.

As a parent of four young men and as a provider of adolescent health care, I would offer the following ten major areas that each teenage boy should be discussing with his doctor or other health care provider. Ask your male teen if he has ever had a chance to discuss any of these issues with an adult health care provider.

The Ten Hot Questions For Teenage Boys

1. Let’s talk about the role of supplements, vitamins, energy drinks and performance enhancers in your life. Have you ever tried to do anything to change your body? How much do you exercise? Have you ever tried creatine? Do you take protein supplements? How often do you use Red Bull or other energy drinks to stay “charged”?

2. Maybe you aren’t sure yet, but on the spectrum of gay to straight, where do you see yourself?

3. Tell me about your alcohol experience. How often do you have four or more drinks in one evening? How often do you forget what you did the night before? Have you been in trouble with yourself, friends, family, school or the law because of alcohol? Do you know what to do if a friend passes out?

4. Do you know how to do a Testicular Self Exam? Do you do it? Boys are more vulnerable to testicular cancer than girls are to breast cancers. Guess which gets more attention? Boys deserve better.

5. If you are having intercourse, are you using a condom every time? Do you know what to do if you have a condom malfunction? Have you ever heard of Emergency Contraception (the Morning After Pill)? Do you know what HPV is? Do you know that there is a new vaccine coming out that may protect you from this virus?

6. Have you ever been in a sexual situation that you regretted?

7. Are you a smoker? Most smokers would like to quit. Would you? Do you know how? Are you really ready?

8. What questions do you have about your body—either the way it looks or the way it works?

9. What stresses you most and how have you learned to handle stress? What do you do to relax? What seems to work best?

10. Is there anyone in your life--friend, family, peer—who worries you particularly? Anyone have an eating disorder, a drinking problem, a problem with anger management?

These are the bare bones of the adolescent interview which is best conducted in private with assurance of confidentiality in an atmosphere that is conducive to conversation. I’ve found that almost all boys--when given a chance--will talk about themselves and their lives. They will move beyond the stereotypical one word answer or shrug and share some of the details. In so doing, they establish a connection to an adult who is willing to understand them in their subtlety and uniqueness.

When a boy’s mother comes into the consultation room at the end of a visit and says: ”Did he say anything?” or “What did he talk about?” I am gratified to realize that her son has been able to open up to an adult about private issues—ones that for him are often equally pressing as they are for girls-- for what might be the first time. And, of course, what he said, stays between him and me.

When the concerns of boys are taken as seriously as those of girls, we as a culture will have begun to pave the way for them to flourish along side their sisters.

Dr. Engelland has a practice in Mamaroneck devoted to Adolescent Primary Care. She can be reached at 698-5544. Have a teen health question? Use the form below to send it to Dr. Engelland. Please note: Dr Engelland cannot respond privately to individual queries online. Comments are welcome and anonymous questions may be answered in future columns. Serious medical problems should be referred to your own physician.

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